Chemotherapy

Tom will be starting a new chemo treatment this week. It's called Folfiri, but every time I hear it pronounced it sounds like Full Fury. Sounds appropriate.  The first chemo was call Folfox or 5FU which also sounds appropriate. FU

We have learned that they never repeat a chemo treatment.  Once you finish one treatment they will not repeat it but may change one of the ingredients.  I haven't figured out why yet. We met with Dr. DaGraca and looked at Tom's PET scan together, which showed that the inoperable tumor on his sacrum, which was dormant for a while, is showing molecular activity again.  The Folfiri is supposed to stop that cancer from growing and spreading.

Folfiri is made up of Fluorouracil, an antimetabolite,  which interferes with cells DNA and RNA.  It targets rapidly dividing cells, which cancer cells are, but so are hair follicles, the lining of the gastrointestinal tract and bone marrow cells. Leucovorin a "reduced folic acid" enhances the effectiveness of the Fluorouracil.   So the chemo kills the cancer cells and keeps them from reproducing but also kills many healthy fast dividing cells.  The cancer cells affected can't repair themselves, but the healthy cells can.   That's why they wait around two weeks before the next treatment.  It gives the healthy cells time to repair and rebuild. Tom had these two drugs last summer and they did get rid of the rectal tumor he had, but this time the third drug will be Irinotecan.

Irinotecan is called an antineoplastic or cytotoxic. It belongs to a class of chemotherapy drugs called plant alkaloids. Irinotecan specifically interferes with the action of topoisomerase enzymes which control the manipulation of the structure of DNA necessary for replication.  With this drug there is more of a chance that Tom will loose his hair and maybe have some digestive issues. We won't know for sure until he starts the treatment.

One difference this time is that they will train me to disconnect him at home and put everything into a hazard bag until the return for the next treatment.  He will get the Irinotecan first for a couple hours and then come home with the Fluorouracil pumping for two days until I disconnect him.

So that's what's coming up.  We will just have to wait and see how Tom responds.

I just spent too long looking for chemotherapy clip art, photos and cartoons to liven up this post. I could not find anything that I deemed appropriate at this time, so you get to see the rabbit in my yard and a flower  I saw on a recent walk.

The Long and Winding Road

Right after Tom had his PET scan we discussed whether or not he wanted to hear the results before or after Amanda's wedding on April 8. Being it was only a few days, he decided to tell the doctor to wait until after the wedding to discuss the results. I was supposed to email his oncologist with this request, but before I got around to it the phone rang and Tom picked it up. Tom went out on the deck while he spoke with doctor DaGraca. He came in and told me that the scan showed some active cancer again in the same area (it had not spread) and that we would meet with the doctor to plan more treatment.

We will meet with the doctor later this week. I'm pretty sure more chemo is on the agenda. Today Tom took that day long road trip with his long time friend, Tom B. They are headed to the coast to visit old friends and relatives. So the answer to "how is Tom feeling?" that I get often, is pretty well, from my point of view. He responds that he feels fine if I inquire but he is obviously feeling fatigued on some days and he has some neuropathy in his feet. We have been out hitting tennis balls a couple more times, had a fun wedding weekend, and he's out on a road trip today.  I just took a springtime walk through Hillsboro and am now at Insomnia Coffee doing what every single other person in this place is doing: using the free internet. Every, single, person.  Spooky, but I'm one of them.


Last Spring, when Amanda started planning the wedding and Tom was diagnosed,  she was concerned about having the wedding quickly to assure her dad's presence. We told her not to rush because we really didn't know what the future held.   A couple weeks ago she came by and practiced dancing for a few minutes with her dad. She wanted to have a father daughter dance and feel relaxed about it. BRAG ALERT: I helped choose the couples first dance song (In My Life by the Beatles) and father/daughter song (Wildflowers by Tom Petty).  Well, I gave her lists with suggestions and had Facebook friends give their suggestions also. I kind of know Amanda's taste at least as far as what she would not like.

(If you are reading this just to check on Tom, STOP right now. I'm talking about the wedding from now on. You should have stopped a paragraph ago.)


So....It really was a beautiful, happy wedding. Amanda was a nervous wreck the month before but she was serenely calm and happy on the day. The Albertina Kerr center was a beautiful setting and the volunteer servers did a great job of serving dinner, wine and cake. Albertina Kerr provides programs and services to children and adults with developmental and mental disabilities. Aaron has volunteered there and all the people there seem to know and love him.  I took photos until my battery started dying. Allison discovered I still had my GPS on and about 50 pages open. My last photo was of Amanda feeding Aaron cake.

Blogger is not letting me move the photos individually or write captions. That colorful mailbox and street number photo was originally near the top but shomehow popped down here to attach itself to the other photos.     Allison did her sister's hair and make-up in the third floor boudoir area. I helped her into her dress and put on her veil. Many other people took photos and of course the professional photographer snapped thousands. It will be fun to see other photos of the celebration. The kids did good!